Metachromatic Leukodystrophy Panel
Summary and Pricing 
Test Method
Sequencing and CNV Detection via NextGen Sequencing using PG-Select Capture Probes| Test Code | Test Copy Genes | Panel CPT Code | Gene CPT Codes Copy CPT Code | Base Price | |
|---|---|---|---|---|---|
| 3285 | Genes x (2) | 81479 | 81405(x1), 81479(x3) | $990 | Order Options and Pricing |
Pricing Comments
Testing run on PG-select capture probes includes CNV analysis for the gene(s) on the panel but does not permit the optional add on of exome-wide CNV analysis. Any of the NGS platforms allow reflex to other clinically relevant genes, up to whole exome or whole genome sequencing depending upon the base platform selected for the initial test.
An additional 25% charge will be applied to STAT orders. STAT orders are prioritized throughout the testing process.
This test is also offered via a custom panel (click here) on our exome or genome backbone which permits the optional add on of exome-wide CNV or genome-wide SV analysis.
Turnaround Time
3 weeks on average for standard orders or 2 weeks on average for STAT orders.
Please note: Once the testing process begins, an Estimated Report Date (ERD) range will be displayed in the portal. This is the most accurate prediction of when your report will be complete and may differ from the average TAT published on our website. About 85% of our tests will be reported within or before the ERD range. We will notify you of significant delays or holds which will impact the ERD. Learn more about turnaround times here.
Targeted Testing
For ordering sequencing of targeted known variants, go to our Targeted Variants page.
Clinical Features and Genetics
Clinical Features
Metachromatic leukodystrophy (MLD, OMIM 250100) is a lysosomal storage disorder due to the abnormal degradation of sulfatide and its subsequent accumulation, mainly in the nervous system. The lysosomal degradation of sulfatide requires both the enzyme arylsulfatase A or ARSA (encoded by the ARSA gene) and the sphingolipid-activator protein 1 or SAP-1 (encoded by the PSAP gene). While most patients with MLD have deficiency in the ARSA enzyme, some patients have deficiency in SAP-1. MLD is a progressive neurodegenerative disease. Three clinical subtypes are distinguished on the basis of the age of onset.
1) Late infantile MLD is characterized by onset before the age of two years and death by the age of five. Symptoms begin with a decline of physical and mental abilities after a few months of normal development and progress to blindness, deafness, paralysis, and difficulty in swallowing (Masters et al. Arch Dis Child 39:345-355, 1964).
2) Juvenile MLD is characterized by onset between five and ten years of age and death by the age of twenty. Symptoms include slow deterioration of speech, gait and posture, spasticity, and dystonia (Schutta et al. J Med Genet 3:86-91, 1966).
3) Adult MLD is characterized by onset after the age of sixteen, unsteady gait, and slow neurological progression with cognitive loss (Müller et al. J Neurol Sci 9:567-584, 1969).
Genetics
All forms of MLD are inherited with an autosomal recessive manner. They are caused by variants in the ARSA gene (Gieselmann et al. Proc Natl Acad Sci USA 86:9436-9440, 1989) or the PSAP gene (Kretz et al. Proc Natl Acad Sci USA 87:2541-2544, 1990). To date, ~150 and ~10 variants have been reported in the ARSA and PSAP genes, respectively. They are distributed along the entire coding regions of the genes and occur in patients from various ethnic groups.
Clinical Sensitivity - Sequencing with CNV PG-Select
Currently not known.
Testing Strategy
This panel provides 100% coverage of all coding exons of the genes listed, plus ~10 bases of flanking noncoding DNA. We define coverage as ≥20X NGS reads or Sanger sequencing.
Indications for Test
Candidates for this test are patients with MLD.
Candidates for this test are patients with MLD.
Genes
| Official Gene Symbol | OMIM ID |
|---|---|
| ARSA | 607574 |
| PSAP | 176801 |
| Inheritance | Abbreviation |
|---|---|
| Autosomal Dominant | AD |
| Autosomal Recessive | AR |
| X-Linked | XL |
| Mitochondrial | MT |
Diseases
| Name | Inheritance | OMIM ID |
|---|---|---|
| Metachromatic Leukodystrophy | AR | 250100 |
| Sphingolipid Activator Protein 1 Deficiency | AR | 249900 |
Related Test
| Name |
|---|
| PGxome® |
Citations
Ordering/Specimens
Ordering Options
We offer several options when ordering sequencing tests. For more information on these options, see our Ordering Instructions page. To view available options, click on the Order Options button within the test description.
myPrevent - Online Ordering
- The test can be added to your online orders in the Summary and Pricing section.
- Once the test has been added log in to myPrevent to fill out an online requisition form.
- PGnome sequencing panels can be ordered via the myPrevent portal only at this time.
Requisition Form
- A completed requisition form must accompany all specimens.
- Billing information along with specimen and shipping instructions are within the requisition form.
- All testing must be ordered by a qualified healthcare provider.
For Requisition Forms, visit our Forms page
If ordering a Duo or Trio test, the proband and all comparator samples are required to initiate testing. If we do not receive all required samples for the test ordered within 21 days, we will convert the order to the most effective testing strategy with the samples available. Prior authorization and/or billing in place may be impacted by a change in test code.
Specimen Types
Specimen Requirements and Shipping Details
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ORDER OPTIONS
View Ordering Instructions1) Select Test Type
2) Select Additional Test Options
No Additional Test Options are available for this test.